Doctor Name: | STEPHEN BLAISE CHROMIAK |
NPI Number: | 1124085048 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 00017665 |
Business Practice Address: | 251 N Bayou St Mobile, AL - 366035827 |
Business Phone Number: | 2516908847 |
Business Fax Number: | 2516908859 |
Mailing Address: | 251 N Bayou St, MOBILE |
State: | AL |
Postal Code: | 366035827 |
Phone Number: | 2516908847 |
Fax Number: | 2516908859 |
NPI Enumeration Date: | 04/26/2006 |
NPI Last Update Date: | 01/31/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 00017665 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |